TY - JOUR
TI - Peri-Procedural Platelet Reactivity in Percutaneous Coronary Intervention
AU - Alexopoulos, D.
AU - Xenogiannis, I.
AU - Vlachakis, P.
AU - Tantry, U.
AU - Gurbel, P.A.
JO - Thrombosis and Haemostasis
PY - 2018
VL - 118
TODO - 7
SP - 1131-1140
PB - Georg Thieme Verlag
SN - 0340-6245
TODO - 10.1055/s-0038-1649484
TODO - antithrombocytic agent;  antithrombocytic agent, clinical assessment;  clinical effectiveness;  clinical practice;  disease association;  human;  meta analysis (topic);  outcome assessment;  patient safety;  percutaneous coronary intervention;  platelet reactivity;  randomized controlled trial (topic);  Review;  thrombocyte activation;  thrombocyte aggregation;  thrombocyte function;  adverse event;  bleeding;  blood;  clinical decision making;  coronary artery disease;  coronary artery thrombosis;  drug effect;  drug resistance;  metabolism;  risk assessment;  risk factor;  thrombocyte;  treatment outcome, Blood Platelets;  Clinical Decision-Making;  Coronary Artery Disease;  Coronary Thrombosis;  Drug Resistance;  Hemorrhage;  Humans;  Percutaneous Coronary Intervention;  Platelet Activation;  Platelet Aggregation Inhibitors;  Risk Assessment;  Risk Factors;  Treatment Outcome
TODO - Platelet activation and aggregation play a pivotal role in thrombotic complications occurring during percutaneous coronary intervention (PCI), and peri-PCI anti-platelet therapy represents a standard of care. High platelet reactivity prior to PCI has been correlated with an increased incidence of peri-procedural myonecrosis. Pre-PCI platelet reactivity predicts post-PCI platelet reactivity and has a prognostic impact on subsequent ischaemic and bleeding events, so as the platelet inhibition measured post-PCI. Many anti-platelet treatment strategies, including aspirin, glycoprotein IIb/IIIa inhibitors, P2Y 12 receptor blockers and vorapaxar, are being used in the routine clinical practice to modify platelet reactivity at each stage, e.g. pre-, during and post-PCI. Anti-platelet strategies with a 'stronger and faster' pharmacodynamic effect than clopidogrel have been mostly adopted in patients with acute coronary syndromes. However, several issues regarding the anti-platelet treatment such as benefits/risks of anti-platelet therapy pre-treatment and duration, and definite association between speed and potency of various anti-platelet agents and clinical outcomes remain controversial. We believe that a better understanding of peri-PCI platelet reactivity and its relations to outcomes may lead to the development of more effective and safe treatment strategies. © 2018 Georg Thieme Verlag KG.
ER -